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Individual
REBEKAH SMITH
Active
Individual
REBEKAH SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000020992
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000020992
BOARD OF CERTIFICATION
—
Enumeration date
04/18/2017
Last updated
09/16/2020
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